Rare Complications of Lumboperitoneal Shunts: Abdominal Cerebrospinal Fluid Pseudocysts in Adults

TL;DR

This paper reports a rare case of an abdominal CSF pseudocyst in an adult after a lumboperitoneal shunt, emphasizing the importance of early diagnosis and reoperation.

Contribution

The paper presents a rare complication of lumboperitoneal shunts in adults and highlights diagnostic and treatment strategies.

Findings

Abdominal CSF pseudocysts are rare after lumboperitoneal shunts in adults.

Reoperation with catheter repositioning resolved symptoms in the reported case.

Shuntography and abdominal CT are effective for diagnosing pseudocysts.

Abstract

Abdominal cerebrospinal fluid (CSF) pseudocysts are rare complications of shunt surgery, predominantly reported in pediatric patients undergoing a ventriculoperitoneal (VP) shunt. In contrast, their occurrence following lumboperitoneal (LP) shunt is exceptionally uncommon. We report the case of a 76-year-old woman who presented with recurrent symptoms, including gait disturbance and cognitive decline, approximately three years after undergoing LP shunt placement for idiopathic normal pressure hydrocephalus. Diagnostic imaging, including shuntography and abdominal computed tomography (CT), revealed an abdominal CSF pseudocyst, likely due to peritoneal adhesions from prior abdominal surgery. Reoperation with catheter repositioning successfully relieved her symptoms. This case highlights the necessity of considering abdominal CSF pseudocysts as a differential diagnosis for shunt malfunction, particularly in patients with a history of abdominal surgery. Early diagnostic procedures, such as shuntography and abdominal CT, are critical for timely intervention and symptom resolution.

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